[Risk factors for complications of ureterolithotripsy]
E A Mamedov1, V V Dutov1, V V Bazaev1
1GBUZ Moscow district Moscow Regional Research Clinical Institute named after M.F. Vladimirsky, Moscow, Russia.
Urologiia (Moscow, Russia : 1999)
|September 8, 2020
Summary
Ureterolithotripsy complications are linked to stone size, location, impaction, and hydronephrosis. Preoperative drainage reduces intraoperative risks, while large perforations significantly increase stricture formation risk.
Area of Science:
- Urology
- Endourology
- Nephrology
Background:
- Ureterolithotripsy is a common procedure for ureteral stones.
- Complications can arise, impacting patient outcomes.
- Identifying risk factors is crucial for improving safety.
Purpose of the Study:
- To identify key risk factors for ureterolithotripsy complications.
- To analyze the impact of stone characteristics and preoperative management on outcomes.
Main Methods:
- Retrospective analysis of 545 ureteroscopies in 506 patients.
- Evaluation of preoperative and intraoperative factors.
- Statistical analysis of complication rates and risk factors.
Main Results:
- Overall complication rate was 22.4%.
- Increased risk associated with larger stone size, proximal location, prolonged impaction (>3 weeks), and hydronephrosis.
- Preoperative drainage (stenting or nephrostomy) reduced intraoperative complication risk (OR=0.35, p=0.03).
- Small ureteral perforations increased complication risk 7.5-fold; large perforations increased stricture risk 64-fold.
Conclusions:
- Ureterolithotripsy complication rates are influenced by stone size, location, impaction, hydronephrosis, and bacteriuria.
- Pre- and intraoperative drainage are critical for reducing complications.
- Minimizing intraoperative trauma, especially ureteral perforation, is essential for preventing strictures.
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